Pedodontics (Pediatric Dentistry)

What is Pediatric Dentistry?

Pedodontics (Pediatric Dentistry), is a field of dentistry that begins with preventive dentistry applications on children aged 0-15, followed by the treatment of milk and permanent teeth of all kinds, teeth traumas, and treatment. Pediatric treatment requires special attention. Knowing the child's psychology well, familiarizing them with the dentist chair without scaring them, informing them about oral hygiene, and assuring that they live with healthy teeth and gums throughout their lives is the main purpose of Pediatric Dentistry.

The Significance of Milk Teeth in Children

The primary function of milk teeth is to facilitate a proper diet. Besides, proper speech ability development depends on the presence of milk teeth. Parents ignore the importance of milk teeth because they are temporary. This leads to negligence of their oral hygiene, causing tooth decay. It should not be forgotten that untreated milk tooth decay causes pain, bad odor, trouble with mastication, malnutrition, and an unesthetic image. Milk teeth lost prematurely due to untreated caries may lead to crookedness, jaw bone anomalies, and general health problems in the future.

There are 20 milk teeth.

The spaces between milk teeth are considered normal because they provide space for permanent teeth.

Tooth decay can occur on milk teeth. It is essential to treat tooth decay.

If milk teeth are inflamed and the roots are radiographically ideal, root canal treatment should be performed. If the tooth does not heal with root canal treatment, the tooth must be extracted.

If milk teeth are extracted prematurely, permanent teeth may not be able to settle properly as they lose the guidance of the milk teeth during the eruption phase.

When Do the Milk Teeth Erupt? When Do They Fall Off?

The first milk teeth in children begin erupting between 6th-8th months and the eruption is completed around the 30th month. Permanent tooth eruption and milk teeth fall-off begins at the age of 6 and continues until the age of 13. Milk molars in the back of the mouth will stay till the ages 10-12 and provide masticatory ability. Due to this fact, it is important to treat and preserve them.

Is It Necessary For My Child To be Examined by a Pedodontist?

The first dental experience of your child is a beginning that will have a lifetime effect of how he or she will feel about dentistry. A negative introduction will bring fear and insecurity and as a result, it will affect the following dental visits in the future. Therefore, the dentist who will take care of your child's dental health must be a specialized pedodontist who excels at communicating with children. The first visit should be planned right after the first tooth erupts.

All the necessary treatments for children are applied by pedodontists. Maintaining good oral and dental hygiene is possible by keeping a regular schedule of appointments every 6 months. During these follow-ups, all kinds of problems affecting oral and dental hygiene can be found. The key point here is early diagnosis and treatment. Early diagnosis will have a positive impact on the child's physical and emotional development.

How Shall I Prepare My Child For His/Her First Exam?

Before bringing your child to the clinic, he or she should be briefly informed about why this visit is going to take place. Parents' worried and uneasy attitudes and the sharing of their own negative experiences near the child will pose a negative example for the child. In addition, it is extremely wrong to make the child fearful of the terms 'doctor' and 'needle'. Observing as their parents receive dental treatments will encourage the children.

How Is the Pedodontic Exam Performed For a Child?

The first examination of a child patient begins with communication between the dental professional and the child along with their parents. After the initial meeting, the patient's medical and dental history is taken. Afterwards, clinical and radiographical examination is performed. Following the examination, the patient and their family are informed about the diagnosis and treatment plan. Pedodontists implement various methods to protect milk and permanent teeth from several dental conditions such as tooth decay and periodontal diseases. These methods include teaching the concept of oral hygiene, getting the child to adopt the habit of brushing, systemic and topical fluoride applications, and application of fissure sealants.

Clinical Practice and Procedures

Behavior Management Techniques

Children may feel anxious or frightened during dental appointments. Therefore, various behavior management techniques are used to help children feel relaxed and at ease. Time is taken to explain procedures to children in a language they can understand, and they are encouraged to ask questions.

Positive reinforcement techniques such as praise and rewards are also used to encourage good behavior. For children who need additional support, sedation or general anesthesia may be used. However, these techniques are only used when necessary and after careful consideration of the child's medical history and individual needs.

Dental Growth and Development

Understanding tooth growth and development is very important in pediatric dentistry.

Tooth growth and development should be closely monitored, and attention should be paid to potential problems such as crowding, malocclusion, or tooth decay. Early diagnosis and intervention can prevent more serious dental problems from occurring in the future.

Flouride Applications

Considered the most effective form of treatment in preventive dentistry, fluoride applications can be employed on healthy individuals, patients who are prone to tooth decay, for sensitivity and erosion treatment, and patients who need special care because of their systemic conditions. Treatment frequency and doses may vary according to the patient's age and risk of tooth decay.

Fissure Sealants

Recesses and grooves on molar teeth's biting surfaces create regions for food to stick and stay in. Tooth decay starts in these regions which are hard to clean up.

The fissure sealant provides a surface that's easy to brush and also forms a shield that keeps food and bacteria from getting into the grooves in the teeth and causing tooth decay. Following the clinical applications, it is reported that tooth decay is decreased by 70%-80%.

Space Maintainers

Milk teeth have a vital role in your child's facial and jawbone development. Some of the milk teeth have to stay in the mouth until the age of 12. However, all milk teeth are replaced by permanent teeth at this age. It is quite difficult for milk teeth to survive up to this age if they are not protected properly. Even the loss of milk teeth may cause serious orthodontic conditions in the future. Various treatments are applied to preserve the milk teeth. Filling and root canal treatments can be applied to milk teeth just like adults. However, it is necessary to protect the spaces of milk teeth lost early due to trauma or caries with space maintainers. When milk teeth are lost early, the teeth surrounding the extraction area may fall into the extraction space and fill the area until the permanent teeth erupt. This may cause the teeth to come out from a different point or remain impacted. Space maintainers can be manufactured from metal or plastic. Fixed or removable space maintainers are prepared according to the number of prematurely lost milk teeth and their localization. After the impression is taken by the dentist, the technician prepares the space maintainer in the lab. Afterward, the prepared space maintainer is attuned to the patient by the dentist. The patient uses the space maintainer under dental professional supervision and the maintainer is removed when the milk teeth begin erupting.

What Are The Functions Of Space Maintainers?

It prevents the extraction site from being concealed by other teeth and preserves this space until the permanent tooth erupts to facilitate the eruption in an ideal position.

It aids in preventing orthodontic problems which may appear in the future.

Since it keeps the teeth in their ideal positions, it prevents crowding. Thus, it provides advantages such as beautifully aligned teeth, easily brushed teeth, and less interdental decay formation.

Fixed Space Maintainers

These are used in single-milk tooth loss. Things to keep in mind when using are:

When there is a problem or the space maintainer is dislodged, it is required to inform your pedodontist.

Sticky food should not be chewed in the area of the space maintainer.

A follow-up appointment is required after 3 months.

Removable Space Maintainers

These are used in more than one milk tooth loss. These types of space maintainers are apparatuses that can be removed by the patient.

Things to keep in mind when using are:

It should be removed during meals.

They should also be brushed after brushing your teeth before going to bed.

If any fracture occurs in the space maintainer, report it to your pedodontist immediately.

Go for a follow-up appointment every 3 months.

Emergencies in Pedodontics

My child has a toothache, what should I do?

Your child's toothache is most likely due to decay. First of all, his/her teeth should be brushed to remove all the food particles and the interdental spaces should be flossed. If necessary, painkillers should be given and an appointment should be scheduled from your pedodontist as soon as possible. In these cases, random antibiotic use is wrong and this decision must be left to your pedodontist. Under no circumstances should the aching area be applied with a hot compress or aspirin.

If My Child Falls and The Milk Teeth is Dislodged, What Shall I Do?

It is recommended to visit your pedodontist as soon as possible. Completely dislodged milk teeth must not be placed in their sockets again because this may harm permanent teeth developing underneath them.

If My Child Falls and a Permanent Tooth is Dislodged, What Shall I Do?

Firstly, the dislodged tooth must be found. The tooth should be held without touching the root and only be rinsed with clean water. If the tooth is preserving its integrity, it must be placed into its socket. The tooth must be prevented from dislodging by getting the child to bite on gauze or clean cloth. If the tooth cannot be placed, it can be carried in cold milk, water, or your child's saliva. It is recommended to visit your pedodontist as soon as possible. If it's later hours, parents should head to a hospital's tooth clinic. Treatments applied immediately after trauma have a much higher chance of success.

What Shall I Do If A Fracture Forms On The Tooth As A Result Of Trauma?

It is recommended to contact your pedodontist as soon as you can. If the cracked fragment can be found, it must be preserved in cold milk or water. This fragment may be used in restoring the tooth. Treatments performed as soon as possible will prevent bigger problems from manifesting.

What Shall I Do If A Fracture Forms On My Child's Jaw Area?

Because there may be head trauma in cases like these, emergency medical attention is required. The fractures in this area must be examined by medical doctors, followed by oral and maxillofacial surgeons, and treated accordingly.

Is It Possible To Protect My Child From Dental Trauma?

If you have a toddler, plastic caps should be placed on the pointy ends of furniture that your child may bump into.

During car travel, it is a must to use child car seats buckled up with a seat belt.

Thanks to the mouthguards prepared by your dentist, children who practice sports such as basketball, football, boxing, skiing, cycling, and skating can be protected from tooth fractures and soft tissue injuries.

My child's space maintainer is dislodged/broken, What Shall I Do?

If the space maintainer is loose or has a broken piece, it should be removed from the mouth if possible. If it cannot be removed and causes discomfort in soft tissue, it is recommended to contact your pedodontist and protect the area with cotton wool.